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首页> 外文期刊>The Internet Journal of Emergency and Intensive Care Medicine >Outcome Of Trauma Admissions In An Intensive Care Unit In The Niger Delta Region Of Nigeria
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Outcome Of Trauma Admissions In An Intensive Care Unit In The Niger Delta Region Of Nigeria

机译：尼日利亚尼日尔三角洲地区重症监护病房的创伤入院结果

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BACKGROUNDTrauma, mostly from head injuries, has been found to be the leading cause of admissions in an intensive care unit (ICU) in Nigeria. The outcome of management of patients with trauma in the ICU at the University of Port Harcourt Teaching Hospital (UPTH) is not known.OBJECTIVE The aim of this audit was to determine the outcome of management for trauma patients admitted in the ICU at UPTH, and how it could be improved.METHODSAll ICU admissions over a period of 4 years (February 2007-January 2011) at the UPTH were analyzed retrospectively. The proportion of these admissions that were due to trauma and the outcome were noted. Demographic details and other information were obtained from the admissions records of the patients and their case notesRESULTS A total of 529 patients were admitted. Two hundred and fifty four (48.0%) were males, while 275 (52.0%) were females. Their ages were between 4 months and 82 years. Postsurgical patients contributed 226 (41.4%) of all admissions, while 132 (25%) of the admissions were for trauma cases. Other reasons for admission included medical conditions, 109 (20.6%), and burns, 62 (11.7%). The length of stay in the unit ranged from one day to fifty-three days, with a mean of approximately 10 days. A total of 217 (41.02%) patients died in the hospital.Fifty-three (40.2%), of the132 trauma patients, died during admission in the ICU. Eighty-one (61.4%) of all trauma patients had head injury. Thirty-nine (48.1%), of all 81 head injury patients, died during admission. Thus, head injury was responsible for 39 (73.6%) of all 53 deaths caused by trauma.CONCLUSIONSHead injury was responsible for majority of the trauma admissions in the ICU. Mortality rate for trauma patients admitted in the ICU was very high. It was even higher for those patients admitted with head injury. Better therapeutic and monitoring equipment and further training of medical and nursing staff of the ICU are needed to reduce these high mortality rates. Also, improvement in the pre-hospital management of the trauma patient to prevent secondary brain injury can increase survival for head injured patients. Introduction The University of Port Harcourt Teaching Hospital (UPTH) is the major health care facility in the Niger Delta region of Nigeria. Admission of patients into the present intensive care unit at the hospital started in February 2007. Prior to this time, the hospital had an 8-bed high-dependency unit (HDU). Severely ill patients were treated there, but there were no mechanical ventilators or multi-parameter patient monitors as are available in the present ICU. The intensive care unit in UPTH has from its inception been staffed by the Department of Anaesthesiology and directed by a specialist Anaesthesiologist, who also had additional training in intensive care medicine. Patients are admitted in this general ICU if they have any of the diseases or conditions listed on the Diagnosis model of the Guidelines for ICU Admission, Discharge, and Triage, issued by the Society of Critical Care Medicine1, and also if their medical conditions appear reversible with ‘‘reasonable prospect of substantial recovery’‘2. Discharge from the ICU is done when the patient’s physiological status has stabilized and the need for ICU monitoring and care is no longer necessary. A study at an ICU in Nigeria identified trauma as the leading cause for admissions and that head injury accounted for most of the trauma admissions3.This is the first study of the outcome for trauma patients admitted in this ICU, and the aim was to determine how often trauma is the cause of admissions in the ICU, the outcome of treatment for these patients and the aspects of intensive care that need to be improved upon for better outcome Methodology After obtaining institutional research ethical committee approval, this study was conducted retrospectively by reviewing the admissions records and case notes of patients admitted to the 8-bed Intensive Care Unit in UPTH in th
机译：背景技术在尼日利亚，重症监护病房（ICU）的主要病因是创伤，主要是头部受伤。目的尚不清楚在哈科特港大学教学医院（UPTH）的ICU中接受创伤治疗的患者的治疗结果。目的本次审核的目的是确定在UPTH的ICU中接受治疗的创伤患者的治疗结果，以及方法回顾性分析UPTH在4年期间（2007年2月至2011年1月）的所有ICU入院率。记录这些因创伤和结局而入院的比例。从患者的入院记录及其病例记录中获得人口统计学详细信息和其他信息。结果总共入院529例患者。男性为254（48.0％），而女性为275（52.0％）。他们的年龄在4个月至82岁之间。手术后患者占所有入院病例的226（41.4％），而其中132例（占25％）是创伤病例。入院的其他原因包括医疗状况109（20.6％）和烧伤62（11.7％）。该单元的停留时间为一天到五十三天不等，平均约为10天。共有217名患者（41.02％）在医院死亡。132名创伤患者中有53例（40.2％）在重症监护病房住院期间死亡。所有创伤患者中有八十一（61.4％）人患有头部受伤。全部81例头部受伤患者中有39例（48.1％）在入院期间死亡。因此，颅脑外伤是造成外伤造成的全部53例死亡中的39例（73.6％）。结论颅脑外伤是造成ICU大部分外伤的原因。重症监护病房（ICU）收治的创伤患者的死亡率很高。对于那些因头部受伤而住院的患者，这一比例更高。为了降低这些高死亡率，需要更好的治疗和监测设备以及对ICU的医护人员进行进一步的培训。而且，改善创伤患者的院前管理以防止继发性脑损伤可以增加颅脑损伤患者的生存率。简介港口哈科特大学教学医院（UPTH）是尼日利亚尼日尔三角洲地区的主要卫生保健机构。该医院于2007年2月开始接纳患者进入目前的重症监护室。在此之前，该医院拥有8张床的高依赖性病房（HDU）。在那里接受了重症患者的治疗，但是目前的ICU中没有机械呼吸机或多参数患者监护仪。 UPTH的重症监护室从成立之初就由麻醉学系配备，并由专业的麻醉师指导，后者还接受了重症监护医学的额外培训。如果患者患有重症监护医学会1发布的《 ICU入院，出院和分诊指南》诊断模型中列出的任何疾病或病症，并且其病情看来可逆，则可以进入该普通ICU具有“大幅度恢复的合理前景” 2。当患者的生理状况稳定并且不再需要ICU监视和护理时，即可从ICU出院。尼日利亚ICU的一项研究确定创伤是住院的主要原因，并且头部受伤是创伤住院的主要原因3.这是该ICU收治的创伤患者结局的第一项研究，目的是确定如何通常，创伤是导致ICU入院的原因，这些患者的治疗结果以及需要改善以改善治疗效果的重症监护方面。方法论在获得机构研究伦理委员会的批准后，本研究通过回顾性研究进行了回顾性研究。 UPTH 8床重症监护病房住院患者的入院记录和病例记录

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